A farmer who is working in poultry developed acute onset of fever with chills. On physical examination, there is hepatosplenomegaly and lymphadenopathy. Blood culture shows Brucella abous. He must have got the infection through all the following ways, EXCEPT:
**Core Concept**
Brucellosis is a zoonotic infection caused by bacteria of the genus Brucella, primarily Brucella melitensis, B. abortus, B. suis, B. canis, and B. ovis. It is transmitted to humans through contact with infected animals or their products, including contaminated meat, dairy products, and aborted fetuses. Brucellosis is characterized by its acute onset of fever, chills, and systemic symptoms, often accompanied by hepatosplenomegaly and lymphadenopathy.
**Why the Correct Answer is Right**
Brucellosis is primarily a zoonotic disease, meaning it is transmitted from animals to humans. The bacteria are typically shed in the milk, urine, and feces of infected animals, and can be transmitted to humans through contact with these bodily fluids or contaminated products. The farmer in this scenario likely acquired the infection through direct contact with infected animals or their products, such as through handling infected meat or raw milk. Man-to-man transmission of Brucella is extremely rare, if not impossible, making option C the correct answer.
**Why Each Wrong Option is Incorrect**
**Option A:** Infected meat is a common route of transmission for Brucellosis, as the bacteria can be present in the meat of infected animals. This option is a plausible route of transmission.
**Option B:** Ingestion of raw milk is also a potential route of transmission, as the bacteria can be present in the milk of infected animals. This option is a possible way the farmer could have acquired the infection.
**Option D:** Contact with aborted fetuses is another possible route of transmission, as the bacteria can be present in the tissues of infected animals. This option is a plausible way the farmer could have acquired the infection.
**Clinical Pearl / High-Yield Fact**
Brucellosis is often referred to as "undulant fever" due to its characteristic fever pattern, which can fluctuate between high and low temperatures over several days. This clinical correlation is an important diagnostic clue for healthcare providers.
**✓ Correct Answer: C. Man to man**